Method to promote hair growth and/or delay or treat hair loss by administering a TGF-β antagonist or inhibitor

ABSTRACT

The present invention provides methods for promoting hair growth and/or treating or preventing hair loss (alopecia) by contacting the cells with a TGF-β antagonist or inhibitor either alone or in combination with other alopecia-inhibiting compounds.

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.60/858,592, filed on Nov. 13, 2006. The entire teachings of the aboveapplication are incorporated herein by reference.

GOVERNMENT SUPPORT

This invention was made with government support under grant numberAR052578 awarded by National Institutes of Health. The government hascertain rights in the invention.

BACKGROUND OF THE INVENTION

Alopecia (hair loss) is a common condition that results from diversecauses. For example, adrenergic alopecia (common baldness) is seen inthe vast majority of adult males and is considered physiologic and partof the aging process. Besides the loss of hair, the length and diameterof each hair will be reduced in the adjacent areas even though thefollicles remain intact.

Telogen effluvium is a transient, reversible, diffuse shedding of hairin which a high percentage of hair follicles enter the telogen phaseprematurely as a result of physical or mental illness. Among the mostimportant factors incriminated are childbirth, high fever, hemorrhage,sudden starvation, accidental or surgical trauma, severe emotionalstress, and certain drugs.

Alopecia areata is an immunologic alopecia characterized by the abruptonset of sharply defined areas of hair loss. In the most severe cases,the scalp will develop total hair loss (alopecia totalis) or the hairloss will involve the whole body surface (alopecia universalis). Most ofthe patients will run an unpredictable and relapsing course withmultiple episodes of hair loss and regrowth. Only about 20 to 30 percentwill have a single reversible episode. Regrowth of hair is common withinseveral months, but in many instances is not complete, and relapses arecommon. Alopecia areata may be associated with autoimmune diseases suchas vitiligo, pernicious anemia, collagen disease, and endocrinopathies.

Traumatic alopecia is induced by physical trauma, of which the two mostimportant groups, from the therapeutic standpoint are trichotillomaniaand alopecia resulting from cosmetic procedures or improper hair care.Trichotillomania is a compulsive habit in which the individualrepeatedly pulls or breaks off his or her own hair in a partiallyconscious state similar to thumb sucking or nail biting. Traumaticalopecia from cosmetic procedures is done consciously in ill-advisedindividuals and is almost exclusively seen among females. Sometimes thistype of alopecia is associated with folliculitis induced by theocclusive effect of the oily cosmetics used in the procedure.

Anagen effluvium is a temporary alopecia caused by the inhibition ofmitosis in the hair papilla by certain cytotoxic drugs, leading toconstriction of the hair shaft or to complete failure of hair formation.In particular, alopecia frequently occurs in cancer patients who aretreated with chemotherapeutic drugs such as cyclophosphamide (CY) and/orirradiation. Such agents damage hair follicles which contain mitoticallyactive hair-producing cells. Such damage may cause abnormally slowgrowth of the hair or may lead to frank loss. While various attemptshave been made to protect against alopecia or abnormal rates of hairgrowth during such treatments, there remains a need for an agent thatprevents damage to hair follicles in a safe and effective manner.

Alopecia may also result from nutritional deficiencies and metabolicdefects. Caloric deprivation must be very severe to produce hair loss.Increased shedding sometimes occurs after marked weight loss forobesity. Anemia, diabetes, hyper- and hypovitaminosis, and zincdeficiency may also lead to alopecia.

Treatments for androgenetic alopecia have been ineffective in inducingregrowth. The use of cyclic estrogen therapy in females with anestrogen-dominant contraceptive or topical estrogen has been advocatedto reduce the rate of hair loss, but results are not impressive. Theclaim that topical testosterone induces the growth of terminal hairs inbald scalp of males has not been confirmed.

There have been some indications that minoxidil (Rogaine®, Upjohn), apotent vasodilator, has been effective in causing scalp hair regrowth inpatients with androgenetic alopecia, but the results have been mixed.Thus, there remains a need in the art for methods of treating andpreventing the various types of alopecia.

Transforming growth factor-β (TGF-β) is a family of structurallyhomologous dimeric proteins; three mammalian isoforms (TGF-β₁, TGF-β₂,TGF-β₃) share 70% sequence identity and exhibit distinct functions invivo. All three TGF-β isoforms are potent growth inhibitors for mostcell types, induce apoptosis in certain cell types and arephysiologically important. TGF-β isoforms regulate multiple biologicalprocesses, including hair growth. TGF-β has been implicated in promotingthe regression phase (catagen) of hair growth cycle by inducing cellulargrowth inhibition or apoptosis during anagen-catagen transition. Hairfollicles are composed primarily of epithelial and dermal components.

The hair growth cycle is coordinated with the interactions of epithelialand dermal components. Dermal papilla cells (DPCs), which are androgentarget cells, are believed to mediate androgenetic alopecia byandrogen-induced secretion of TGF-β. The secreted TGF-β induces growthinhibition and/or apoptosis of hair follicle epithelial cells, resultingin loss of hair follicles and resultant alopecia. Increasing evidencealso indicates that TGF-β is involved in the pathogenesis of alopeciacaused by other factors. TGF-β therefore, appears to be the target forinnovative treatment of alopecia. The present invention provides TGF-βpeptantagonists and derivatives thereof that are effective in promotinghair growth.

SUMMARY OF THE INVENTION

The present invention provides methods for promoting hair growth and/ortreating or preventing hair loss (alopecia) by contacting the cells witha TGF-β antagonist or inhibitor either alone or in combination withother alopecia-inhibiting compounds.

DESCRIPTION OF THE INVENTION

Unless otherwise indicated, the term “active agent” as used hereinrefers to the group of compounds comprising Transforming Growth Factor β(TGF-β) antagonists or inhibitors with specificities toward the type VTGF-β receptor and other TGF-β receptor types (type I, type II, and typeIII receptors) including peptides containing the W(or R)XXD motif(wherein X represents any amino acid) in the sequences and furtherincluding such peptides conjugated to carriers such as proteins orsynthetic polymers, such as PEG, for example. “Other compounds, fortreating or preventing alopecia” include but are not limited tominoxidil, procyanidin B-3, finasteride, keratinocyte growth factor(KGF), fibroblast growth factor (FGF), epidermal growth factor (EGF),butyric acid and its derivatives, ammonium trichloro(dioxyethylene-0,0′) tellurate (AS101), interleukin 1, prostaglandin E2,cyclosporine A, corticosteroids such as dexamethasone, Imuvert™(immunomodulatory preparation of membrane and ribosomes from Serratiamarcescens), cholesterol and calcitriol (1,25 dihydroxyvitamin D).

As used herein, “alopecia” refers to hair loss associated withconditions including, but not limited to, adrenergic alopecia, telogeneffluvium, alopecia areata, traumatic alopecia, anagen effluvium, andhair loss associated with nutritional deficiencies, metabolic defects,marked weight loss, diabetes, hyper- and hypovitaminosis, and zincdeficiency, alopecia vulgaris, alopecia pustulosa, alopeciaerythrodermica, alopecia arthropathica, paraalopecia, palmoplantarpustulosis, all forms of ichthyoses, e.g. ichthyosis vulgaris andcongenital ichthyoses, keratodermias of all types, e.g., palmoplantarkeratodermia, other genodermatoses with pathological cornificationdisorders, e.g. Darier's disease, further lichen ruber planus andpityriasis rubra pilaris.

By “treating or preventing alopecia” is meant the ability to cure,reduce or prevent one or more clinical symptoms of alopecia, including,but not limited to, hair loss, cornification, scaling, uneven thickness,persistent itch, inflammation, and rapid epithelial cell turnover in theskin. Treating alopecia also includes the promotion of hair growth atthe site of the hair loss. The methods of the invention also encompasspromotion or stimulation of hair growth in general (e.g. to thickennaturally thin hair). The inventors have previously discovered thatthree chemically synthesized peptides β₁ ²⁵ (41-65) (SEQ ID NO: 4), β₂²⁵ (41-65) (SEQ ID NO: 5), and β₃ ²⁵ (41-65) (SEQ ID NO: 6) collectivelyreferred to herein as “peptantagonists” or “antagonists”, whose aminoacid sequences were derived from and correspond to the 41 st to 65thamino acid residues of TGF-β₁ (SEQ ID NO: 1), TGF-β₂ (SEQ ID NO: 2), andTGF-β₃ (SEQ ID NO: 3) respectively, inhibit the binding of radiolabeledTGF-β₁, TGF-β₂, and TGF-β₃ to TGF-β receptors in mink lung epithelialcells which are a standard model system for investigating TGF-β actionand other cell types in humans and animals (i.e. cellular receptors). Itwas also discovered that at least four consecutive amino acidscomprising W(or R)XXD (wherein X is any amino acid) motif in thesequences, determines their potencies and that they block TGF-β-inducedgrowth inhibition and TGF-β-induced expression of PAI-1 in mink lungepithelial cells and other cell types (U.S. Pat. No. 6,500,920 issuedDec. 31, 2002). As was previously disclosed by the inventors, suchpeptides are effective in inhibiting, ameliorating or reversing theeffects of TGF-β in biological systems including but not limited toreducing scarring wounds, to prevent lung injury in adult respiratorydistress syndrome (ARDS), and injuries of other tissues caused bypharmacological agents (e.g. bladder injury caused by cyclophosphamide).

The inventors have also discovered that derivatives of the peptideantagonists of the invention are also potent inhibitors of TGF-β. Thesederivatives of TGF-β₃ ²⁵ peptantagonists β₁ ²⁵ (41-65) (SEQ ID NO: 4),β₂ ²⁵ (41-65) (SEQ ID NO: 5), and β₃ ²⁵ (41-65) (SEQ ID NO: 6) arecollectively referred to herein interchangeably as “TGF-β peptantagonistderivatives”, “TGF-β antagonist derivatives” or “TGF-β peptidederivatives”.

However, prior to the present invention, there was no expectation by oneof skill in the art that the TGF-β-derived peptides or derivativesthereof are useful in methods to promote hair growth and/or to treat orprevent alopecia.

Preferred active agents in accordance with the present inventioncomprise TGF-β peptantagonists, β₁ ²⁵ (41-65) (SEQ ID NO: 4), β₂ ²⁵(41-65) (SEQ ID NO: 5, and β₃ ²⁵ (41-65) (SEQ ID NO: 6), whose aminoacid sequences were derived from and correspond to the 41st to 65thamino acid residues of TGF-β₁ (SEQ ID NO: 1), TGF-β₂ (SEQ ID NO: 2), andTGF-β₃ (SEQ ID NO: 3). In addition to these peptides, variousnonpeptidic agents (e.g., peptidomimetics) having the requisite TGF-βantagonist activity are further contemplated for use in accordance withthe present invention.

In one preferred embodiment, the invention provides TGF-β peptantagonistderivatives which are the result of the conjugation of polyethyleneglycol (PEG) to β₁ ²⁵ (41-65) (SEQ ID NO: 4), β₂ ²⁵ (41-65) “(SEQ ID NO:5), and β₃ ²⁵ (41-65)” (SEQ ID NO: 6), referred to herein as “PEG-β₁²⁵”, “PEG-β₂ ²⁵” and “PEG-β₃ ²⁵”, respectively, and collectivelyreferred to herein as “PEG-β²⁵ peptantagonists”. The conjugation of PEGto form peptides of the invention is referred to herein as “pegylation”and the peptides formed thereby are referred to herein as “pegylated”.Pegylated (PEG-) TGF-β peptantagonist derivatives can be generated indifferent molecular weight forms. The PEG group may be of any convenientmolecular weight and may be linear or branched. The average molecularweight of the PEG will preferably range from about 2 kiloDalton (“K”) toabout 100 K, more preferably from about 5 K to about 50 K, morepreferably from about 20 K to about 40 K, and most preferably from abut20 K to about 30 K (the term “about” indicating that in preparations ofPEG, some molecules will weigh more, some less, than the statedmolecular weight). One skilled in the art will be able to select thedesired polymer size based on such considerations as the desired dosage;circulation time; resistance to proteolysis; effects, if any, onbiological activity; ease in handling; degree or lack of antigenicity;and other known effects of PEG on a therapeutic peptide.

The PEG groups will generally be attached to the compounds of theinvention via acylation or reductive alkylation through a reactive groupon the PEG moiety (e.g., an aldehyde, amino, thiol, or ester group) to areactive group on the inventive compound (e.g., an aldehyde, amino, orester group). The TGF-β peptantagonist derivatives of the invention canalso contain two PEG moieties that are covalently attached via areactive group on each of the PEG moieties. Each PEG moiety preferablyhas a molecular weight of about 10 kilodaltons (10K) to about 60K. Morepreferably, each of the two PEG moieties has a molecular weight of about20K to about 40K, and still more preferably between about 20K and about40K. Still more preferably, each of the two PEG moieties has a molecularweight of about 20K. One skilled in the art will be able to select thedesired polymer size based on such considerations as the desired dosage;circulation time; resistance to proteolysis; effects, if any, onbiological activity; ease in handling; degree or lack of antigenicity;and other known effects of PEG on a therapeutic peptide.

In one preferred embodiment, the PEG-β²⁵ peptantagonists are pegylatedat the N-terminal alpha-amino group and at the epsilon-amino group (e.g.the lysine residue) of the β²⁵ peptantagonists. In one embodiment β¹²⁵(41-65) (SEQ ID NO: 8) is pegylated at the N-terminal alpha-amino groupand at the epsilon-amino group to form PEG-β₁ ²⁵ as is indicated in boldin the following sequence:

NH2-ANFSLGPSPYIWSLDTQYSKVLALY-COOH. (SEQ ID NO: 8)

A useful strategy for the pegylation of synthetic peptides consists ofcombining, through forming a conjugate linkage in solution, a peptideand a PEG moiety, each bearing a special functionality that is mutuallyreactive toward the other. The peptides can be easily prepared withconventional solid phase synthesis as is known in the art and includethose described in Merrifield (1973), Chem. Polypeptides, pp. 335-61(Katsoyannis and Panayotis eds.); Merrifield (1963), J. Am. Chem. Soc.85: 2149; Davis et al. (1985), Biochem. Intl. 10: 394-414; Stewart andYoung (1969), Solid Phase Peptide Synthesis; U.S. Pat. No. 3,941,763;Finn et al. (1976), The Proteins (3rd ed.) 2: 105-253; and Erickson etal. (1976), The Proteins (3rd ed.) 2: 257-527. The peptides are“preactivated” with an appropriate functional group at a specific site.The precursors are purified and fully characterized prior to reactingwith the PEG moiety. Ligation of the peptide with PEG usually takesplace in aqueous phase and can be easily monitored by reverse phaseanalytical HPLC. The pegylated peptides can be easily purified bypreparative HPLC and characterized by analytical HPLC, amino acidanalysis and laser desorption mass spectrometry.

For a discussion of other strategies for the pegylation of peptides thatwould result in suitable TGF-β peptantagonist derivatives of theinvention include those modifications that are described in U.S. Pat.Nos. 6,838,076 and 7,084,245, incorporated herein by reference.

The invention also includes TGF-β peptide derivatives and TGF-βpeptantagonist derivatives comprising hydrophilic protein, peptide ororganic polymer derivatizations. Suitable hydrophilic polymers include,but are not limited to, polyalkylethers as exemplified by polyethyleneglycol and polypropylene glycol, polylactic acid, polyglycolic acid,polyoxyalkenes, polyvinylalcohol, polyvinylpyrrolidone, cellulose andcellulose derivatives, dextran and dextran derivatives. The TGF-βpeptide derivatives and TGF-β peptantagonist derivatives of theinvention may comprise modifications and derivatizations at randompositions within the molecule, or at predetermined positions within themolecule and may include one, two, three or more attached chemicalmoieties.

The hydrophilic polymer or protein derivatizations may be of anymolecular weight, and may be branched or unbranched. The size of thehydrophilic polymer or protein derivatizations may vary depending on thedesired therapeutic profile (e.g., the duration of sustained releasedesired; the effects, if any, on biological activity; the ease inhandling; the degree or lack of antigenicity and other known effects ofthe hydrophilic polymer derivatization to the TGF-β peptantagonistderivatives).

There are a number of attachment methods available to those skilled inthe art. Preferred for therapeutic purposes is attachment at an aminogroup, such as attachment at the N-terminus or lysine group of the TGF-βpeptantagonist. TGF-β peptantagonist derivatives chemically modified atthe N-terminus may be accomplished by reductive alkylation, whichexploits differential reactivity of different types of primary aminogroups (lysine versus the N-terminal) available for derivatization inthe TGF-β peptantagonist. Under the appropriate reaction conditions,substantially selective derivatization of the protein at the N-terminuswith a carbonyl group containing polymer is achieved.

Examples of TGF-β peptantagonist derivatives comprising hydrophilicmoieties attached at various positions within the molecule, includeshort, hydrophilic polymers such as polyglutamate, polyaspartate,polylysine or polyarginine attached to the N and/or C termini of a TGF-βpeptantagonist derivative of the invention. TGF-β peptantagonistderivatives include the addition of 4 to 6 glutamate or aspartateresidues at the N-termini or the C-termini of TGF-β peptantagonists.Preferred TGF-β peptantagonist derivatives include 6-glutamate,6-aspartate, 4-lysine and 4-arginine derivatives.

Water soluble proteins such as albumin, (e.g. bovine serum albumin,human serum albumin), are also suitable for conjugation to peptides β₁²⁵ (41-65) (SEQ ID NO: 4), β₂ ²⁵ (41-65) (SEQ ID NO: 5), and β₃ ²⁵(41-65) (SEQ ID NO: 6).

In another embodiment of the invention variants of peptantagonists β₃ ²⁵(41-65) (SEQ ID NO: 4), β₂ ²⁵ (41-65) (SEQ ID NO: 5), and β₃ ²⁵ (41-65)(SEQ ID NO: 6), are provided in which cysteine-44 and cysteine-48 werereplaced by serine residues. These C44S/C48S versions designated β₁ ²⁵C44S/C48S (SEQ ID NO: 8), β₂ ²⁵ C44S/C48S (SEQ ID NO: 9), and β₃ ²⁵C44S/C48S (SEQ ID NO: 10), had the same TGF-β antagonist activity. TheC44S/C48S versions had better stability in solution during storage.

In another embodiment, the C44S/C48S variants designated β₁ ²⁵ C44S/C48S(SEQ ID NO: 8), β₂ ²⁵ C44S/C48S (SEQ ID NO: 9), and β₃ ²⁵ C44S/C48S (SEQID NO: 10), include further derivations as discussed above with regardto the conjugation of PEG (or other water soluble proteins) at variouspositions on the molecule (e.g. at the N-terminal alpha-amino groupand/or at the epsilon-amino group (e.g. the lysine residue) and/or theattachment of hydrophilic moieties (e.g. 6-glutamate, 6-aspartate,4-lysine and 4-arginine) at various positions in the molecule, andpreferably at the N-terminus or C-terminus of the TGF-β peptantagonists.For example, in one embodiment a preferred peptide comprises β₁ ²⁵C44S/C48S (SEQ ID NO: 8) that has been derivitized with 6 glutamate atthe N-terminus and is designated herein as 6-E-β₁ ²⁵ C44S/C48S (SEQ IDNO: 7). Examples of other peptantagonist derivatives comprisinghydrophilic moieties include but are not limited to: 6-E-β₂ ²⁵ C44S/C48S(SEQ ID NO: 11), and 6-E-β₃ ²⁵ C44S/C48S (SEQ ID NO: 12).

The polypeptides of the instant invention may be synthesized by anyconventional method, including, but not limited to, those set forth U.S.Pat. No. 6,500,920 incorporated herein by reference. Briefly, the aminoacid sequences of all TGF-β peptantagonists and TGF-β peptantagonistderivatives were derived from those of TGF-β₁ (SEQ ID NO: 1), TGF-β₂(SEQ ID NO: 2), and TGF-β₃ (SEQ ID NO: 3). The peptides were synthesizedusing solid phase methods and purified using Sephadex G-25 columnchromatography and HPLC. The purity of the synthesized peptides wasverified by automated MALDY-TOF/TOF and MS/MS analyses.

In one aspect of the present invention, a method of treating orpreventing alopecia by administering to a patient in need thereof anamount effective to treat or prevent alopecia of the TGF-βpeptantagonists or TGF-β peptantagonist derivatives in accordance withthe invention, is disclosed, either alone, combined, or in furthercombination with other compounds or treatments effective for treating orpreventing alopecia.

In one preferred embodiment, the method is used to limit alopecia in apatient subjected to radiation or chemotherapy treatment and/or promotehair growth in such patient.

The active agents may be made up in a solid form (including granules orpowders) or in a liquid form (e.g., solutions, suspensions, oremulsions), and may be subjected to conventional pharmaceuticaloperations such as sterilization and/or may contain conventionaladjuvants, such as stabilizers, wetting agents, emulsifiers,preservatives, cosolvents, suspending agents, viscosity enhancingagents, ionic strength and osmolality adjustors and other excipients inaddition to buffering agents. Suitable water soluble preservatives whichmay be employed in the drug delivery vehicle include sodium bisulfite,sodium thiosulfate, ascorbate, benzalkonium chloride, chlorobutanol,thimerosal, phenylmercuric borate, parabens, benzyl alcohol,phenylethanol or antioxidants such as Vitamin E and tocopherol andchelators such as EDTA and EGTA. These agents may be present, generally,in amounts of about 0.001% to about 5% by weight and, preferably, in theamount of about 0.01 to about 2% by weight.

For administration, the active agents are ordinarily combined with oneor more adjuvants appropriate for the indicated route of administration.The compounds may be admixed with lactose, sucrose, starch powder,cellulose esters of alkanoic acids, stearic acid, talc, magnesiumstearate, magnesium oxide, sodium and calcium salts of phosphoric andsulphuric acids, acacia, gelatin, sodium alginate, polyvinylpyrrolidine,and/or polyvinyl alcohol, and tableted or encapsulated for conventionaladministration. Alternatively, the compounds of this invention may bedissolved in saline, water, polyethylene glycol, propylene glycol,carboxymethyl cellulose gel solutions, ethanol, corn oil, peanut oil,cottonseed oil, sesame oil, tragacanth gum, and/or various buffers.Other adjuvants and modes of administration are well known in thepharmaceutical art. The carrier or diluent may include time delaymaterial, such as glyceryl monostearate or glyceryl distearate alone orwith a wax, or other materials well known in the art.

For use in treating or preventing alopecia, the active agents may beadministered by any suitable route, including local delivery,parentally, transdermally, intradermally or topically in dosage unitformulations containing conventional pharmaceutically acceptablecarriers, adjuvants, and vehicles. The term parenteral as used hereinincludes, subcutaneous, intravenous, intramuscular, intrasternal,intratendinous, intraspinal, intracranial, intrathoracic, infusiontechniques or intraperitoneally.

For topical administration, the active agents may be formulated as isknown in the art for direct application to a target area. Conventionalforms for this purpose include wound dressings, coated bandages or otherpolymer coverings, ointments, lotions, creams, pastes, jellies, sprays,shampoos, salves, transdermal patches, and aerosols. The percent byweight of the active agent of the invention present in a topicalformulation will depend on various factors, but generally will be from0.01% to 50% of the total weight of the formulation, and typically 1-10%by weight.

Liquid, emulsion or gel dosage forms for topical or intradermaladministration may include pharmaceutically acceptable emulsions,solutions, suspensions, syrups and elixirs containing inert diluentscommonly used in the art, such as water. Such compositions may alsocomprise adjuvants, such as wetting agents, emlusifying and gel agentsand -dermal permeability enhancers, flavoring and perfuming agents.

The dosage and treatment regimen for treating or preventing alopeciawith the active agents is based on a variety of factors, including theage, weight, sex, medical condition of the individual, the severity ofthe condition, the route of administration, and the particular compoundemployed. Thus, the dosage regimen may vary widely, but can be on theorder of between 0.01 mg/cm² and 10 mg/cm² of the active agents per cm²of body surface are useful for topical methods as disclosed herein,preferably between about 0.1 mg/cm² and 5 mg/cm², more preferablybetween about 0.1 mg/cm² and 2.5 mg/cm², and most preferably betweenabout 0.1 mg/cm² and 1 mg/cm² For example, treatment of alopecia usingthe composition may be accomplished by subcutaneous or topicalapplication of the composition to the affected areas one or more timesper day for as long as is needed.

It may also be envisaged that the composition comprising at least oneTGF-β antagonist is in liposomal form. Thus, the antagonist encapsulatedin the liposomes can be delivered selectively to the hair follicle. Suchcomposition may be applied to alopecic areas of an individual's scalpand hair, and is optionally left in contact for several hours and arinsing operation is optionally carried out. It is possible, forexample, to apply the composition containing the active agent in theevening, to keep it in contact throughout the night and optionally toshampoo the hair in the morning. These applications can be repeateddaily for one or more months depending on the individual. The treatmentprocess has the characteristics of a cosmetic process insofar as itallows the aesthetic appeal of the hair to be enhanced by making it morevigorous and improving its appearance.

The pharmaceutical compositions of the invention may be formulated as toprovide rapid, sustained or delayed release of the active ingredientsafter administration to the patient by employing procedures well knownin the art. The formulations may also contain substances that diminishproteolytic degradation and promote absorption such as, for example,surface active agents.

In a further aspect, the present invention provides kits for treating orpreventing alopecia, wherein the kits comprise an effective amount ofthe active agents of the invention to treat or prevent alopecia, andinstructions for using the amount effective of active agent to treat orprevent alopecia.

In a preferred embodiment, the kits also contain an effective amount totreat or prevent alopecia of one or more other compounds, including butnot limited to minoxidil, procyanidin B-3, finasteride, phosphatidicacid, keratinocyte growth factor (KGF), fibroblast growth factor (FGF),epidermal growth factor (EGF), zinc ions butyric acid and itsderivatives, ammonium trichloro(dioxy ethylene-0,0′) tellurate (AS101),interleukin 1, prostaglandin E2, cyclosporine A, corticosteroids such asdexamethasone, Imuvert™ (immunomodulatory preparation of membrane andribosomes from Serratia marcescens), cholesterol and calcitriol (1,25dihydroxyvitamin D). Effective dosages of the active agents of theinvention to treat or prevent alopecia are between about 0.1 mg/cm² and1 mg/cm², as discussed above.

In another aspect of the invention, pharmaceutical compositions areprovided that comprise an amount effective to treat or prevent alopeciaof one or more of the active agents of the invention in combination withan amount effective to treat or prevent alopecia of minoxidil,procyanidin B-3, finasteride, phosphatidic acid keratinocyte growthfactor (KGF), fibroblast growth factor (FGF), epidermal growth factor(EGF), butyric acid and its derivatives, ammonium trichloro(dioxyethylene-0,0′) tellurate (AS101), interleukin 1, prostaglandin E2,cyclosporine A, corticosteroids such as dexamethasone, Imuvert™(immunomodulatory preparation of membrane and ribosomes from Serratiamarcescens), cholesterol and calcitriol (1,25 dihydroxyvitamin D).

The invention is further illustrated by the following non limitingexamples.

Example 1 Hair Growth Studies in Full-Thickness Porcine Burn Wounds

Preparation of 6-E (Glutamate)-β²⁵ Peptantagonists:

TGF-β peptantagonists with amino acid sequences corresponding toresidues 41-65 of TGF-β₁ (SEQ ID NO: 8) and TGF-β₂ (SEQ ID NO: 9), andTGF-β peptantagonist 6-β₁ ²⁵ (SEQ ID NO: 7), which have additional 6glutamate residues at the N-termini were synthesized and purified asdescribed previously. Sterile IntraSite gel was obtained from Smith andNephew Medical, Ltd. (UK) and mixed with TGF-β peptantagonists inphosphate-buffered saline at a ratio of 3:1 (v/v).

Animals:

Female pigs (Yorkshire strain, house inbred and specific pathogen-free)weighing 20-25 kg were used in the experiments. The pigs were housed inindividual rooms. They were fed standard laboratory chow and water adlibitum. All study protocols were reviewed and approved by therespective institutional animal care committees.

Preparation of IntraSite Gel Containing TGF-β Peptantagonist 6-β₁ ²⁵:

One milliliter of sterile 3 mM each of TGF-β peptantagonist 6-E-β₁ ²⁵(SEQ ID NO: 7), in phosphate-buffered saline (PBS) or 1 ml of sterilePBS (vehicle) was vigorously mixed with 3 ml of IntraSite gel using two10 ml syringes connected with a three-way connector. The IntraSite gelcontaining 6-E-β₁ ²⁵ and IntraSite gel containing buffer (vehicle) werestable for at least 2 months. The biological activity of TGF-βpeptantagonist in IntraSite gel containing 6-E-β₁ ²⁵ was analyzed bydetermining its activity to block ¹²⁵I-TGF-β binding to TGF-β receptorsin mink lung epithelial cells. Two concentrations of TGF-βpeptantagonist (0.15 and 0.6 mM) were found to be effective in promotinghair growth.

Hair Growth in Full-Thickness Pig Skin Burn Wound Model:

Four pigs weighing 20-25 kg were anesthetized by intramuscular injectionof ketamine (5 mg/kg), strenil (cazaporonum) (20 mg/kg), and atropine (5mg/kg). Six uniform burn wounds (110° C., 30 s) were then madesymmetrically on the back of each pig using a modified soldering ironwith a flat contact area of 20 cm². The burn injury was equivalent to afull-thickness burn injury in humans and uniformly caused coagulationand necrosis of dermis, and complete loss of hair in the burn lesion.After wounding, IntraSite gels containing 6-E-β₁ ²⁵ and buffer vehicle(as control) were applied to the pig burn wounds. All wounds weredressed with paraffin gauze. TGF-β peptantagonist gel or control gel wasapplied to the wounds every 2 days for the first 10 days and twice aweek for the next 30 days. All wounds were cleaned and measured beforeeach application of the IntraSite gel.

Measurement of Hair Growth:

Hair growth was assessed by measuring hair number and hair length in theburn lesion and around the lesion area. Hair growth was monitored every2 days for the first 10 days and twice a week for 30 more days. Hairgrowth expressed as a percent of the original wound size was calculated.

Results

The pig model is commonly used in skin injury (e.g., burn) experimentsbecause porcine skin is anatomically very similar to human skin. It wasused to determine the ability of 6-E-β₁ ²⁵ peptantagonist to rescue orrestore hair follicles and to promote hair growth in a standardized burninjury. Four pigs weighing 20-25 kg were anesthetized by intramuscularinjection of ketamine (5 mg/kg). A soldering iron with a flat contactarea of ˜20 cm² was used to generate full-thickness burn wounds (110°C., 30 s) at standard sites on the skin of the back. Six thermal burns(three on each side) were created on each pig. After wounding, twolesions were treated with a thin layer of IntraSite gel containing6-E-β₁ ²⁵ (SEQ ID NO: 7) (0.15 and 0.6 mM); two received gel alone andtwo received no topical applications. All wounds were then bandaged andprotected from potential contact irritation with a fixed frame. 6-E-β₁²⁵ (SEQ ID NO: 7) and vehicle gels were applied every 2 days for thefirst 10 days and twice a week for the next 30 days, at which time hairgrowth was measured and photographed. Each animal served as its owncontrol. The burn wounds at postburn day 0 showed homogeneous necrosis(the white color region). On postburn day 30, wounds treated with 6-E-β₁²⁵ exhibited re-epithelialization and hair growth. The 6-E-β₁ ²⁵peptantagonist appeared to promote hair growth in a dose-dependentmanner. At 0.15 and 0.6 mM, 6-E-β₁ ²⁵ (SEQ ID NO: 7) promoted hairgrowth of 5-10 and 30-40% of the original pre-burn area, respectively.Interestingly, at these dosages, 6-E-β₁ ²⁵ also promoted hair growth inthe area surrounding the burn wound. By contrast, wounds treated withvehicle only (control) exhibited re-epithelialization but did notexhibit any hair growth at postburn day 30 and even in the experimentaltime period (40 days). Furthermore, the control wound did not showaccelerated hair growth in the area surrounding the wound when comparedwith those treated with 6-E-β₁ ²⁵ (SEQ ID NO: 7). This result indicatesthat 6-E-β₁ ²⁵ (SEQ ID NO: 7) is capable of restoring or rescuing hairfollicles and promoting hair growth.

Example 2 Hair Growth Studies in Partial-Thickness Porcine Burn Wounds

Study Protocol and Interventions:

Animals were sedated with Talazine® (Tiletamine and Zolazepam, FortDodge Lab, Fort Dodge, Iowa) 5 mg/kg IM. The pigs were then intubatedendotracheally and maintained under a surgical plane of anesthesia withisoflurane 0.5-2.5% in room air. The flank and back hair was clippedwith hair clippers and the skin was scrubbed with a povidine iodinesolution.

Standardized partial thickness burns were created on the animals' backsand flanks by applying a 2.5 cm by 2.5 cm, 150 gram aluminum barpreheated in hot water to 80° C. The heated bar was wiped dry just priorto application to prevent water droplets from creating a steam burn onthe skin. The bar was then placed at a vertical position perpendicularto the skin's surface and applied for a period of 20 seconds with allpressure supplied by gravity. This burn model results in damage to theupper 30-50% of the dermis and has been shown to be highly reproducible.In order to simulate burn blister debridement and enhance the absorptionof the topical agents, the necrotic epidermis was gently removed byrubbing the burn with dry gauze. Removal of the necrotic epidermisresults in delayed reepithelialization, and increased scar formation¹⁷.Twenty burns were inflicted on each of 2 pigs (evenly distributedbetween both side of the pigs), for a total of 40 burns.

PEG-β₁ ²⁵ Peptantagonist:

The agent used in the studies is PEG-β₁ ²⁵ (SEQ ID NO: 8) Thisparticular peptide was chosen after screening seven pentacosapeptideswhose amino acids overlap and cover most of the human TGF-β₁ molecule,the monomer of which has 112 amino acid residues. The antagonistactivities of the chosen peptide completely inhibited the binding oflabeled TGF-β₁ to its receptor in mink lung epithelial cells. The othersix peptides did not show any effect on labeled TGF-β₁ binding to itsreceptor. Furthermore, the chosen peptide was also shown to block thecellular responses to TGF-β₁ such as DNA synthesis and transcriptionalactivation of PAI-1. Polyethylene glycol propionic acidN-hydroxysuccimide ester (M.W. 5000, 20000 and 30000) were obtained fromNecktar. PEG-TGF-β peptantagonists PEG-β₁₋₃ ²⁵ were prepared by reactingpolyethylene glycol propionic acid N-hydroxysuccimide ester with TGF-βpeptantagonist β₁₋₃ ²⁵ according to the protocol provided by themanufactural company. TGF-β peptantagonist PEG-β₁ ²⁵ in PBS was mixedwith Sterile IntraSite gel from Smith and Nephew Medical, Ltd. (UK) at aratio of 1:3 (v/v).

Hair Growth in Partial-Thickness Pig Skin Burn Wound Model:

The pigs were randomized to treatment with topical PEG-β₁ ²⁵peptantagonist (SEQ ID NO: 8) or its vehicle (carboxy methylcellulose,IntraSite Gel, Smith and Nephew, Largo, Fla.) immediately after injuryand at days 3, 5, 7, 10, 14, 18, 21, and 25. A thin layer of the topicaltreatment was applied with a sterile metal spatula. Group randomizationorder was determined by drawing unlabeled forms from an opaquecontainer. After applying the topical therapy, the burns were coveredwith dry non-adherent gauze (Telfa®, Kendall Company, Mansfield, Mass.).The burned areas were then covered with a gauze bandage roll (Conform®),Kendall Healthcare Products Company, Mansfield, Mass.) and an adhesiveelastic bandage (Elastoplast®, Beiersdorf-Jobst, Inc., RutherfordCollege, N.C.). The adhesive dressing was secured to the skin at adistance from the burns with skin staples. Animals were observedfrequently for signs of pain or discomfort and treated with IMbuprenorphine 0.01 mg/kg as needed.

Dressing changes were performed with each application of the topicalagents. At each dressing change all gauze dressings were removed and thewounds were observed and the study agent was reapplied. All burns werethen re-covered with non-adherent gauze and elastic wrap as previouslydescribed. Full thickness 4-mm punch biopsies (Miltex Instrument CompanyInc., Lake Success, N.Y.) were taken after 7, 10, and 14 days forblinded histopathological evaluation by a board-certifieddermatopathologist masked to treatment assignment. The entire wound wasexcised at 28 days and submitted for histological evaluation. Digitalphotos were taken prior to biopsy to determine the presence of woundcontraction defined as an hourglass like shape. Histopathologicalstudies were done on formalin-fixed, alcohol-dehydrated, xylene-cleared,paraffin-embedded, hematoxylin and eosin stained 5 μm sections usingconventional microscopy.

Outcomes:

The primary outcome was the percent of wounds healing with woundcontraction. Secondary outcomes were percent reepithelialization,percent wound infection, and the percent of wounds with scars extendingthrough the entire thickness of the dermis.

Wound contraction was considered present if the scar had an hourglassconfiguration. The percent reepithelialization was calculated bymeasuring the length of neoepidermis in cross section and dividing it bythe specimen's diameter multiplied by 100 (inter-observer agreement,r=0.99) While there is considerable debate regarding the exactdefinition of wound infection, wounds were considered infected in thepresence of erythema, warmth and/or purulence. Another outcome was thepercentage of wounds with a deep full-thickness scar extending throughthe entire depth of the dermis. A scar is the end result of woundhealing due to dermal damage or loss. It is characterizedhistopathologically by poorly organized thin bundles of collagen thatare observed under polarized light. This measurement has excellentintra-observer reliability (K=0.93).

Data Analysis:

Data analysis was performed using SPSS 14.0 for Windows (SPSS, Inc.,Chicago, Ill.) software. Categorical variables (wound contraction, fullthickness scar) are expressed as the percent frequency of occurrence,and the study groups were compared with χ² tests. Continuous variables(percent reepithelialization) were expressed as means with 95%confidence intervals and compared across groups using a t-test. Thelevel of significance was preset at a P value of 0.05. A sample size of20 burns in each group provided a power of 80% to detect a 25-percentagepoint difference in the percent of contracted wounds.

Results

Twenty burns were treated with a PEG-β₁ ²⁵ peptantagonist (SEQ ID NO: 8)and 20 burns with control vehicle. There were no wound infections in anyof the study groups. The mean percent wound reepithelialization washigher at 7, 10, and 14 days in wound treated with the TGF-Bantagonists, although the differences were not significant (Table 1).

TABLE 1 Partial-thicknness porcine Burn Wound Outcomes PEG-β₁ ²⁵ ControlMean Difference peptantagonist Vehicle (95% CI) Wound infections, No. 00 (%) Percent wound 14.2 (28.8)  6.2 (20.9)  7.9 (−8.2-24.1)reepithelialization, day 7 Percent wound 46.3 (44.4) 25.3 (39.9) 20.9(−6.1-48.0) reepithelialization, day 10 Percent wound 91.9 (25.7) 72.4(41.3) 19.5 (−2.5-41.5) reepithelialization, day 14 No. (%) wounds 18(90)  9 (45) P = 0.006 completed reepithelialized, day 14 No. (%)contracted 7 (35%) 13 (65%) P = 0.025 wounds, day 28 No. (%) deep scars,2 (10%) 12 (60%) P = 0.002 day 28

The percentage of wounds that were completely reepithelialized at 14days after injury was significantly higher in burns treated with thePEG-β₁ ²⁵ than controls (90% vs. 45%, P=0.002). It is important to notethat wounds treated with PEG-β₁ ²⁵ exhibited hair growth whereas woundstreated with vehicle only did not show any hair growth. The percentageof contracted wounds (35% vs. 65%, P=0.02) and full thickness scars (10%vs. 60%, P=0.002) at 28 days was also reduced in the PEG-β₁ ²⁵-treatedgroups. These results indicate that PEG-TGF-β₁ peptantagonist enhanceswound healing and reduces scarring and suggest that PEG-β₁ ²⁵ restoresand rescues hair follicles and promotes hair growth in partial-thicknesspig skin burn wounds.

The patent and scientific literature referred to herein establishes theknowledge that is available to those with skill in the art. All UnitedStates patents and published or unpublished United States patentapplications cited herein are incorporated by reference. All publishedforeign patents and patent applications cited herein are herebyincorporated by reference. All other published references, documents,manuscripts and scientific literature cited herein are herebyincorporated by reference.

While this invention has been particularly shown and described withreferences to preferred embodiments thereof, it will be understood bythose skilled in the art that various changes in form and details may bemade therein without departing from the scope of the inventionencompassed by the appended claims.

1. A method to promote or stimulate hair growth and/or delay or treathair loss in a subject, said method comprising administering aneffective amount of at least one peptide TGF-β receptor antagonist topromote or stimulate hair growth and/or delay or treat hair loss to anindividual in need thereof, wherein said peptide TGF-β receptorantagonist binds to a type I, type II, type III and/or type V TGF-βreceptor and is capable of inhibiting binding of TGF-β to the receptor.2. The method of claim 1 wherein the peptide TGF-β receptor antagonistcomprises an amino acid sequence having at least four contiguous aminoacids comprising W (or R)XXD wherein X is any amino acid.
 3. The methodof claim 2 wherein the amino acid sequence comprises at least 10 aminoacids.
 4. The method of claim 1 wherein the peptide TGF-β receptorantagonist has an amino acid sequence selected from: β₁ ²⁵ (41-65) (SEQID NO: 4), β₂ ²⁵ (41-65) (SEQ ID NO: 5), β₃ ²⁵ (41-65) (SEQ ID NO: 6),β₁ ²⁵ C44S/C48S (SEQ ID NO: 8), β₂ ²⁵ C44S/C48S (SEQ ID NO: 9), and β₃²⁵ C44S/C48S (SEQ ID NO: 10).
 5. The method of claim 4 for treatingalopecia.
 6. The method of claim 5 wherein the alopecia is associatedwith a disorder selected from the group consisting of adrenergicalopecia, telogen effluvium, alopecia areata, traumatic alopecia, anageneffluvium, nutritional deficiencies, metabolic defects, marked weightloss, diabetes, hypervitaminosis, hypovitaminosis, zinc deficiency,alopecia vulgaris, alopecia pustulosa, alopecia erythrodermica, alopeciaarthropathica, para-alopecia, palmoplantar pustulosis, ichthyoses,keratodermias, and genodermatoses with pathological cornificationdisorders.
 7. The method of claim 5 further comprising the step ofadministering a therapeutically effective amount of another compound fortreating alopecia, selected from the group consisting of minoxidil,procyanidin B-3, finasteride, phosphatidic acid, keratinocyte growthfactor, fibroblast growth factor, epidermal growth factor, butyric acidand its derivatives, ammonium trichloro(dioxy ethylene-0,0′) tellurate,interleukin 1, prostaglandin E2, cyclosporine A, corticosteroids,cholesterol and calcitriol.
 8. The method of claim 4 wherein the peptideTGF-β receptor antagonist is a peptide TGF-β receptor antagonistderivative comprising at least one short, hydrophilic polymer attachedto the N and/or C terminus of a peptide TGF-β receptor antagonist. 9.The method of claim 8 wherein the short, hydrophilic polymer is6-glutamate, 6-aspartate, 4-lysine or 4-arginine residues.
 10. Themethod of claim 9 wherein the peptide TGF-β receptor antagonistderivative is: 6-E-β₁ ²⁵ C44S/C48S (SEQ ID NO: 7), 6-E-β₂ ²⁵ C44S/C48S(SEQ ID NO: 11), or 6-E-β₃ ²⁵ C44S/C48S (SEQ ID NO: 12).
 11. The methodof claim 4 wherein the peptide TGF-β receptor antagonist is a pegylatedpeptide TGF-3 receptor antagonist derivative.
 12. The method of claim 11wherein the pegylated peptide TGF-β receptor antagonist derivative ispegylated at the N-terminal alpha-amino group, at the epsilon-aminogroup or at both the N-terminal alpha-amino group and the epsilon-aminogroup.